open access

Vol 5, No 6 (2009)
Review paper
Published online: 2010-03-01
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Drug hypersensitivity reactions and desensitization in oncology

Grzegorz Porębski, Jarosław Woroń, Krzysztof Krzemieniecki
Onkol. Prak. Klin 2009;5(6):244-249.

open access

Vol 5, No 6 (2009)
REVIEW ARTICLES
Published online: 2010-03-01

Abstract

Symptoms of hypersensitivity reactions to antineoplastic agents include pruritus, erythema, facial flushing, fever, tachycardia, dyspnea, rash/hives, headache, chills, weakness, vomiting, burning sensations, dizziness, and edema. Prevention consists of histamine receptor antagonists, steroids and slowing down the infusion rate. Although the reported incidence of hypersensitivity reactions to antineoplastic agents is considered to be low, alternative treatment is usually less effective or hardly available, because of high costs. Rapid desensitization allows patients, who experienced severe hypersensitivity reactions to receive effective first-line therapy for their primary or recurrent cancer. Temporary clinical tolerance is achieved by administering small incremental doses of drug suspected to induce hypersensitivity reaction. So far, desensitization protocols have been described for taxens, platins, doxorubicin and other antineoplastic agents.

Abstract

Symptoms of hypersensitivity reactions to antineoplastic agents include pruritus, erythema, facial flushing, fever, tachycardia, dyspnea, rash/hives, headache, chills, weakness, vomiting, burning sensations, dizziness, and edema. Prevention consists of histamine receptor antagonists, steroids and slowing down the infusion rate. Although the reported incidence of hypersensitivity reactions to antineoplastic agents is considered to be low, alternative treatment is usually less effective or hardly available, because of high costs. Rapid desensitization allows patients, who experienced severe hypersensitivity reactions to receive effective first-line therapy for their primary or recurrent cancer. Temporary clinical tolerance is achieved by administering small incremental doses of drug suspected to induce hypersensitivity reaction. So far, desensitization protocols have been described for taxens, platins, doxorubicin and other antineoplastic agents.
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Keywords

drug hypersensitivity; desensitization; antineoplastic agents

About this article
Title

Drug hypersensitivity reactions and desensitization in oncology

Journal

Oncology in Clinical Practice

Issue

Vol 5, No 6 (2009)

Article type

Review paper

Pages

244-249

Published online

2010-03-01

Bibliographic record

Onkol. Prak. Klin 2009;5(6):244-249.

Keywords

drug hypersensitivity
desensitization
antineoplastic agents

Authors

Grzegorz Porębski
Jarosław Woroń
Krzysztof Krzemieniecki

References (24)
  1. Pichler WJ. Drug hypersensitivity. Karger, Basel 2007: 168–189.
  2. Weiss RB, Bruno S. Hypersensitivity reactions to cancer chemotherapeutic agents. Ann Intern Med. 1981; 94(1): 66–72.
  3. Vervloet D, Durham S. Adverse reactions to drugs. BMJ. 1998; 316(7143): 1511–1514.
  4. Wendel GD, Stark BJ, Jamison RB, et al. Penicillin allergy and desensitization in serious infections during pregnancy. N Engl J Med. 1985; 312(19): 1229–1232.
  5. Pichler WJ. Drug Hypersensitivity. In: Kay AB. ed. Allergy and Allergic Diseases. Wiley-Blackwell, Oxford 2008: 1943–1965.
  6. Castells M. Drug Desensitization in Oncology: Chemotherapy Agents and Monoclonal Antibodies. In: Pichler WJ. ed. Drug hypersensitivity. Karger, Basel 2007: 404–413.
  7. Markman M, Kennedy A, Webster K, et al. Clinical features of hypersensitivity reactions to carboplatin. J Clin Oncol. 1999; 17(4): 1141.
  8. Nikas SN, Voulgari PV, Drosos AA. Urticaria and angiedema-like skin reactions in a patient treated with adalimumab. Clin Rheumatol. 2007; 26(5): 787–788.
  9. Castells MC, Tennant NM, Sloane DE, et al. Hypersensitivity reactions to chemotherapy: outcomes and safety of rapid desensitization in 413 cases. J Allergy Clin Immunol. 2008; 122(3): 574–580.
  10. Morales AR, Shah N, Castells M. Antigen-IgE desensitization in signal transducer and activator of transcription 6-deficient mast cells by suboptimal doses of antigen. Ann Allergy Asthma Immunol. 2005; 94(5): 575–580.
  11. Kook H, Kim KM, Choi SH, et al. Life-threatening carboplatin hypersensitivity during conditioning for autologous PBSC transplantation: successful rechallenge after desensitization. Bone Marrow Transplant. 1998; 21(7): 727–729.
  12. Sims-McCallum RP. Outpatient carboplatin desensitization in a pediatric patient with bilateral optic glioma. Ann Pharmacother. 2000; 34(4): 477–478.
  13. Ogle SK, Rose MM, Wildes CT. Development and implementation of a carboplatin desensitization protocol for children with neurofibromatosis, type 1 and hypersensitivity reactions in an outpatient oncology clinic. J Pediatr Oncol Nurs. 2002; 19(4): 122–126.
  14. Markman M, Zanotti K, Peterson G, et al. Expanded experience with an intradermal skin test to predict for the presence or absence of carboplatin hypersensitivity. J Clin Oncol. 2003; 21(24): 4611–4614.
  15. Gammon D, Bhargava P, McCormick MJ. Hypersensitivity reactions to oxaliplatin and the application of a desensitization protocol. Oncologist. 2004; 9(5): 546–549.
  16. Mis L, Fernando NH, Hurwitz HI, et al. Successful desensitization to oxaliplatin. Ann Pharmacother. 2005; 39(5): 966–969.
  17. Markman M, Kennedy A, Webster K, et al. Paclitaxel-associated hypersensitivity reactions: experience of the gynecologic oncology program of the Cleveland Clinic Cancer Center. J Clin Oncol. 2000; 18(1): 102–105.
  18. Markman M, Kennedy A, Webster K, et al. An effective and more convenient drug regimen for prophylaxis against paclitaxel-associated hypersensitivity reactions. J Cancer Res Clin Oncol. 1999; 125(7): 427–429.
  19. Price KS, Castells MC. Taxol reactions. Allergy Asthma Proc. 2002; 23(3): 205–208.
  20. Lee CW, Matulonis UA, Castells MC. Rapid inpatient/outpatient desensitization for chemotherapy hypersensitivity: standard protocol effective in 57 patients for 255 courses. Gynecol Oncol. 2005; 99(2): 393–399.
  21. Rigatos SK, Tsavdaridis D, Athanasiadis A, et al. Paclitaxel and liposomal doxorubicin (Caelyx) combination in advanced breast cancer patients: a phase II study. Oncol Rep. 2003; 10(6): 1817–1819.
  22. Harrison M, Tomlinson D, Stewart S. Liposomal-entrapped doxorubicin: an active agent in AIDS-related Kaposi's sarcoma. J Clin Oncol. 1995; 13(4): 914–920.
  23. Feldweg AM, Lee CW, Matulonis UA, et al. Rapid desensitization for hypersensitivity reactions to paclitaxel and docetaxel: a new standard protocol used in 77 successful treatments. Gynecol Oncol. 2005; 96(3): 824–829.
  24. Broome CB, Schiff RI, Friedman HS. Successful desensitization to carboplatin in patients with systemic hypersensitivity reactions. Med Pediatr Oncol. 1996; 26(2): 105–110.

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